Assessing maladaptive repetitive thought in clinical disorders: A critical review of existing measures

- Repetitive thinking is a maintaining factor across clinical disorders.
- We highlight disorder-specific and transdiagnostic measures of repetitive thinking.
- Most measures assess disorder-specific thinking (e.g. depressive rumination).
- Measures show small-to-moderate correlations with symptoms of psychopathology.
- Transdiagnostic approaches may aid advances in theory and treatment.

Rumination and worry have recently been grouped under the broader transdiagnostic construct of repetitive thought (Watkins, 2008). The purpose of this review is to provide an overview of scales used to assess repetitive thinking across a broad range of contexts: depression, anxiety, trauma, stress, illness, interpersonal difficulties, positive affect, and so forth. We also include scales developed or adapted for children and adolescents. In the extant literature, measures of repetitive thinking generally show small-to-moderate correlations with measures of psychopathology. This review highlights problems with the content validity of existing instruments; for example, confounds between repetitive thought and symptomatology, metacognitive beliefs, and affect. This review also builds on previous reviews by including newer transdiagnostic measures of repetitive thinking. We hope that this review will help to expand our understanding of repetitive thinking beyond the mood and anxiety disorders, and suggest ways forward in the measurement of repetitive thinking in individuals with comorbid conditions.